| NPI | 1952521122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: SC 8837) |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: MN D12542) |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: IL 021002212) | |
| Enumeration Date | 2007-04-27 |
| Last Update Date | 2019-06-03 |